Confused on how a CCG (clinical commissioning group) is funded? Mystified about the relationship between local authorities and the NHS? Updated last month, The King’s Fund’s handy organograms (US=org chart) explain the formal organization of the NHS, how it is funded by Parliament, and the relationships between entities. The slides are downloadable. There are also two six-minute videos that tackle how NHS and NHS England work. See this page also for links to content on local service design, governance, and regulation, plus NHS finances. How is the NHS structured?
Tender Alerts: Yorkshire assistive tech, Wales DPS for health
Susanne Woodman, our Eye on Tenders, has set her gaze on two high-value UK tender offerings:
- Yorkshire and the Humber: North Yorkshire County Council is seeking a vendor for Assistive Technology Services to enable people to live in their own homes for longer and reduce demand on social care services. The value of the five-year contract is £4.9m with a start of 01 April 2018 ending 31 March 2023. Tenders must be submitted by 17 January 2018. There is not much information on the Gov.UK page and it’s recommended that you contact Tim Wood of the NYCC at tim.wood@northyorks.gov.uk.
- NHS Wales Informatics Service (NWIS): The NHS Wales Shared Services Partnership is seeking multiple vendors for its procurement project establishing a Dynamic Purchasing System (DPS) for Digital Patient Services Partners. According to the tender summary, this will be the first ever DPS created in Health in the UK and within any known ICT market. There are five lots to this tender and it is complicated, so review the information on the Full Notice Text tab on the Sell2Wales site. This Editor suspects the deadline may be in error as it’s out to 30 July 2021!
NYeC sets SHIN-NY 2020 HIE roadmap, awards five leaders at gala
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/11/NYeC-Gala-2017.jpg” thumb_width=”200″ /]The New York eHealth Collaborative’s biennial Gala last Wednesday marked the formal debut of the Statewide Health Information Network for NY (SHIN-NY or ‘shiny’) 2020 Roadmap for development of the state’s Health Information Exchange (HIE). Before an audience of most of NY state’s healthcare organization leaders and key staff, new Executive Director Valerie Grey opened the evening with a topline of the SHIN-NY’s major goals in ensuring a robust HIE supporting value-based care, interoperability including innovations such as blockchain and natural language processing (NLP), public health advocacy, efficiency, and increased affordability. It extends NYeC’s founding goals of connecting providers and achieving the Triple Aim (improved patient experience, population health, at a lower per capita cost–which we don’t hear much about anymore). The full text of the Roadmap is available for download here.
NYeC recognized five healthcare leaders:
Transformative Leader: David Blumenthal, MD, President of The Commonwealth Fund, who is past Information and Innovation Officer at Partners Healthcare in Boston. The Commonwealth Fund is an independent research entity on health and social issues. Most recently, this Editor reviewed their paper on Spanish-language telemedicine assistance services [16 Aug]. Dr. Blumenthal noted the transformative spread of health records, to where a younger generation cannot conceive of dependency on written charts, and access of patients to their personal health records. He also noted the lack of system interoperability and usability. Will there be a disruptive entrant as he predicts in the future?
Honorees:
James (Jim) R. Tallon, Jr., former president of the United Hospital Fund of NY and former chairman of The Commonwealth Fund. He recounted the early years of NYeC (as a board member). In looking at the future, he hopes we can find our way to a more effective public policy. Overall, he believes that healthcare will be better organized and benefit more people.
Paul Macielak, Esq., president and CEO of the NY State Health Plan Association which represents 29 NYS health plans, discussed the benefits of building out ‘the next mile’ — the HIE for the Capital (Albany) region for the consumer and the provider communities.
Patrick Roohan, VP Data Management and Analytic Solutions, MVP Health Care, was formerly the state Deputy Commissioner/Director of the Office of Quality and Patient Safety. He noted healthcare’s growth through technology and the effect it will have on quality and safety.
The night’s final honoree was Eugene (Gene) Heslin, MD, First Deputy Commissioner of the NY State Department of Health (DOH) and a family practice physician from Saugerties. (more…)
Public Health England: we’re hiring to expand digital initiatives
Public Health England is going on a bit of a hiring blitz, with currently nine posts on offer and more to come over the next few months, according to a report on PublicTechnology.net. Digital health is coming up front, with their stated intent to support an in-house user-centered design team and expanding their project- and delivery-management functions. The positions are manager and designer levels. This does seem in concert with NHS England initiatives noted on our most recent Tender Alerts. Those interested should refer to Gov.UK’s page on Working for PHE with links to Civil Service and NHS Jobs. Hat tip to Susanne Woodman of BRE.
And speaking of new jobs, Dr. Mike Short, who was a senior executive for many years with Telefónica (the O2 mobile network) and quite active in advocating digital health, has joined the UK Department for International Trade as their first Chief Scientific Adviser. He is also currently a visiting professor at the universities of Surrey, Coventry, Leeds and Lancaster. Congratulations! Another from PublicTechnology.net
A few short topical items: NHS Digital, DHACA, IET, more
Rob Shaw, NHS Digital’s Deputy CEO, gave a welcome talk at EHI Live on Tuesday encouraging the NHS organisations to become “intelligent” customers. To quote “We have got to make it easier for suppliers to sell into health and social care”. Let’s hope that the message is received and acted on! Until it is, the Kent Surrey and Sussex AHSN is offering help to SMEs to make that first sales – how to book, and to get more details on the event on 23rd November go here.
DHACA’s Digital Health Safety event, in partnership with Digital Health.London on 7th November is proving extremely popular, to the point where it may be oversubscribed soon, so if you want a seat for this really important event for all digital health developers and suppliers, book now.
The IET is running a TechStyle event on the evening of 22 November entitled the world of wearables aimed at people “between 14 and 114”. For today only (1 November) they are offering a special “2 for 1” deal making the already tiny cost essentially insignificant. Book here. Hat tip to Prof Mike Short.
Prof Short has also highlighted a recent report from Agilysis looking at the role digital technology can play in delivering the vital step change our nation’s care services need. It concluded that:
- Leading digital professionals say lack of digital skills biggest risk to transforming care services fit for the 21st century;
- Lack of knowledge of digital tools is largely responsible for delays in embracing new ways of working;
- Believe digital technology could cut costs associated with social care delivery and therefore address the number one issue affecting UK social care today;
- Digital technology can help local authorities manage both demand (improved customer satisfaction) and supply (improves multi-agency working).
There’s a great (more…)
CareRooms: the perils of “Silicon Valley hype” when your customer is the NHS
A cautionary tale of an innovator likely sidelined due to clumsy press talk. The NHS has a problem called bed blocking, where post-acute care patients cannot return home because no one is there to care for them. It was up 40 percent last year. One approach to it has been home/community care combined longer term with telehealth services to reduce unneeded re-admissions. Another is freeing up the bed by placing a patient who does not need direct nursing care in a supervised post-acute room in a setting which provides assistance services.
In the US, many large hospitals and clinics run or partner with hotel-like annexes for recovering patients, usually post-surgical, who need assistance but not direct nursing care or special medical monitoring. The patient remains overnight or for a few days, with or without a private duty nurse, until the person can be discharged to travel home. These recovery centers/hotels, plain to plush, are popular in ‘medical tourism’ cities such as Miami, Houston, and New York, but well-used by locals for many procedures including orthopedic and cosmetic surgery recovery. Regular hotels have also gotten into this act with special services marketed to surgical practices. Recovery hotels and services may or may not be covered by insurance as they are part of hospital or practice referral.
CareRooms’ approach is closer to ‘Airbnb for post-surgical discharge care’. Here this startup, according to its website, arranges rooms in private homes for a fee, equips them appropriately, and the lessor can earn £50/night. The host stays on the premises, microwaves meals and serves drinks, and can be sociable. Other care is provided by CareRooms. The idea is simple, eminently pitchable, and may actually address this NHS problem usefully if supervised properly. The co-founder and medical director of CareRooms, Harry Thirkettle, is a part-time A&E registrar at Southend and was mentored in the NHS Clinical Entrepreneur program; the other co-founder was a program mentor.
And therein lies the catch. The service has not been in trials yet, and here they are offering room lessors without care training £50/night right on the website, which gives the impression that this service is readily available (wrong). How do they provide their ‘other care’ and what is it? How do they equip the room? Recruit and train hosts? How will they scale three rooms to 30 and then 300? And payment–covered or private? All those problematic, unglamorous and sobering things founders learn in early days haven’t been experienced yet. (more…)
Tender Alert: advance notice for NHS England ACS-STP Innovation Framework
Susanne Woodman, our Eye on Tenders, has located another NHS England prior information notice for healthcare technology services. This is for Sustainability and Transformation Partnerships (STPs) and Accountable Care Systems (ACS) for building services around population needs, improving outcomes and quality of care. NHS is seeking “a ‘one stop shop’ framework and contracting vehicle to allow STP and ACS partners to more easily source a range of transformation support.” A description is under VI.3) Additional information. Interested suppliers must register via the NHS Bravo portal at https://nhsengland.bravosolution.co.uk/web/login.html–Bravo will be used to issue further information to interested suppliers. Estimated date of publication of contract notice is 8 December. Tenders Electronic Daily-TED.
Will Japan’s hard lessons on an aging population include those with dementia?
Japan, with over 30 percent of its population over 60 and with no countervailing trend to stop it, is now facing the scourge of dementia. With a WHO-estimated life expectancy of 84, over 4.6 million Japanese have been diagnosed with it. The Japan Times published an estimate (unfootnoted) that 15 percent of Japan’s over-65 population has dementia to some degree. Will Japan, struggling to implement technology to better manage an aging, shrinking population [TTA 24 Oct], turn out to be a model for Western Europe, the US, and their neighbor China in treating older people with cognitive problems with respect and care –or be a cautionary tale?
Two articles in Canada’s Toronto Star and the Japan Times indicate the struggle and the pressure that dementia has placed on an aging Japanese nation. What makes headlines is an unfortunate 91-year-old man in Obu who wanders onto railway tracks (with the family handed the C$39,000 damage bill), the horrific rundown of pedestrians by a 73-year-old who despite a dementia diagnosis just had his driver’s license renewed, and the violent acts around kaigo jigoku, or “caregiver hell” by both family members and paid carers. This is not readily solvable by robots or Paro seals (although self-driving cars would be one huge help).
Japan has pioneered innovation for a better quality of life with dementia, which as typical not all of which can translate to a larger country:
- In 2000, Japan introduced mandatory long-term care insurance, which is paid into starting at age 40. At 65 (or earlier due to disease), you become eligible for a wide range of caring services, with a 10-20 percent service fee attached to discourage overuse. This semi-market-based approached has proven popular with 5.6 million using it in 2013.
- Dementia daycare, which reportedly is used by 6-7 percent of the over-65 population. Healthy stimulating activities in a local home and small group setting, such as food preparation, art therapy, and storytelling can cost as little as C$10 a day.
- Dementia search and rescue, which is organized again on a local basis. Community teams of social workers and medical professionals actively look for people with dementia in homes where, for instance, a wife is caring for a husband who is increasingly forgetful, and suggest some alternatives and respite. Sometimes the approach works, sometimes not, but it shows that the community does not forget about the person and, importantly, the caregiver.
- Short-term stays or respite care (shokibo takino) gives a regular ‘day off’ or a stay of up to 30 days. This also appears to be organized locally.
The Japan Times/Sentaku ‘dementia time bomb’ article is nowhere near as optimistic as the Toronto Star‘s take, advocating instead: (more…)
CVS’ bid for Aetna–will it happen, and kick off a trend? (updated)
We have scant facts about the reported bid of US drugstore giant CVS to purchase insurance giant Aetna for a tidy sum of $200 per share, or $66 billion plus. This may have been in development for weeks or months, but wisely the sides are keeping mum. According to FOX Business, “an Aetna spokesperson declined to chime in on the reports, saying the company doesn’t “comment on rumors or speculation” and to Drug Store News, a CVS Health spokesperson did the same. Aetna’s current market cap is $53 billion, so it’s a great deal for shareholders if it does happen.
Both parties have sound reasons to consider a merger:
- CVS, like all retailers, is suffering from the Amazon Effect at its retail stores
- Retail mergers are done with the Walgreens Boots Alliance–Rite Aid merger going through considerable difficulties until approved last month
- The US DOJ and Congress has signaled its disapproval of any major payer merger (see the dragged-out drama of Aetna-Humana)
- It has reportedly had problems with its pharmacy benefit management (PBM) arm from insurers like Optum (United HealthCare), and only last week announced that it was forming a PBM with another giant, Anthem, called IngenioRx (which to Forbes is a reason why this merger won’t happen–this Editor calls it ‘hedging one’s bets’ or ‘leverage’)
- Aetna was hard hit by the (un)Affordable Care Act (ACA), and in May announced its complete exit from individual care plans by next year. Losses were $700 million between 2014 and 2016, with over $200 million in 2017 estimated (and this is prior to the Trump Administration’s ending of subsidies).
- It’s a neat redesign of the payer/provider system. This would create an end-to-end system: insurance coverage from Aetna, CVS’ Minute Clinics delivering care onsite, integrated PBM, retail delivery of care, pharmaceuticals, and medical supplies–plus relationships with many hospital providers (see list here)–this Editor is the first to note this CVS relationship with providers.
We will be in for more regulatory drama, of course–and plenty of competitor reaction. Can we look forward to others such as:
- Walgreens Boots with Anthem or Cigna (currently at each others’ throats in Delaware court)
- Other specialized, Medicare Advantage/Medicare/Medicaid networks such as Humana or WellCare?
- Will supermarkets, also big retail pharmacy providers, get into the act? Publix, Wegmans, Shop Rite or Ahold (Stop & Shop, Giant) buying regionals or specialty insurers like the above, a Blue or two, Oscar, Clover, Bright Health….or seeking alliances?
- And then, there’s Amazon and Whole Foods….no pharmacy in-house at Whole Foods, but talk about a delivery system?
Also Chicago Tribune, MedCityNews.
UPDATED. In seeking an update for the Anthem-Cigna ‘Who Shot John’ court action about breakup fees (there isn’t yet), this Editor came across a must-read analysis in Health Affairs
CHC breaking news: Qualcomm on 5G’s $1T impact, Think Fast stroke VR
From the Connected Health Conference in Boston
Qualcomm announced today two releases: an analysis on the effects of 5G mobile on the healthcare sector and the Think Fast virtual reality (VR) simulation program for stroke diagnosis.
5G Mobile: Qualcomm’s study, “5G Mobile: Impact on the Health Care Sector”, found that 5G’s increased data speed, reliability, and security will have a substantial and positive impact on healthcare both in quality and financially.
- It will enable the ‘personalization of healthcare’ through permitting the continuous real-time gathering of healthcare data through sensors and on the back end, to process that data usefully. Qualcomm calls this the Internet of Medical Things (IoMT) which works for this Editor as long as the devices and apps are secure. (Having worked in telehealth where network drops and latency in many areas, particularly rural, often made check-in via tablet connectivity a matter of the stars aligning right, this is good news–Ed. Donna)
- It will better support remote diagnosis and imaging, including the application of VR
- It will facilitate distributed computing, which is data processing closer to the patient, for the greater use of predictive analytics
- Faster and more data will help in the transition from volume-based to value-based/outcome-based care
- Financial impact is estimated by IHS Markit at more than $1.1 trillion in global sales in healthcare by 2035. broken down as follows:
- $453bn in the healthcare vertical: hospitals, doctors, medical equipment, pharma
- $409bn in supply chain and related
- $253bn in added value sectors: payers, data analytics providers, cloud data services
The study was authored by Prof. David J. Teece, Tusher Center for Intellectual Capital, Haas School of Business, UC Berkeley, and supported by Qualcomm. Study PDF. Previously in TTA: Ericsson’s less rosy 5G international healthcare survey [TTA 13 June].
Think Fast VR: FAST–Facial drooping, arm weakness, speech difficulties and time to call emergency services–is the acronym for what to watch for when someone is having a stroke. But if you could observe it in reality, it would be far less ambiguous and more memorable. Think Fast is a VR simulation program that lets the user (a med student, nurse, healthcare educator, or average person) observe a stroke’s effects as if it was happening to them. By stepping inside a stroke victim’s world, it educates on warning signs and critical steps for care. It was designed by ForwardXP using Qualcomm’s Snapdragon VR SDK and Unity 5.6 plugin. Stroke is the fifth leading cause of death in America and a leading cause of adult disability–which can be minimized or prevented with quick response within three hours. Video below. Hat tip to Ashley Settle of Weber Shandwick
A random selection of what’s crossed my screen recently
One of the signs of autumn for this editor is the first email from Flusurvey. This is a brilliantly simple system that sends you an email every week asking if you have flu-like symptoms, then produces a map of the UK that gives advance warnings of epidemics. It costs nothing to join and is a great contribution to public health so why not sign up?. (They also have some exciting developments that may surface soon such as a small device that you blow into the connects to a smartphone and can tell almost immediately if you have flu’.)
Increasingly of concern to this editor, due to his deep involvement in digital health regulation, is who is working out how to regulate self-learning algorithms. It is therefore good to see the issue breaking cover in the general press with this article. For what it’s worth this editor’s view is that as technology begins to behave more like humans, albeit in a much faster, and narrow, way by learning as it goes along, perhaps an appropriately adapted use of the way human clinicians are examined, supervised and regulated, might be most appropriate. Sitting next to an AHSN CIO interested in the topic at a Kings Fund event last week, I was pleased to hear him offer precisely the same suggestion, so perhaps there is a little mileage in the idea.
DHACA (disclosure: run by this editor) has just renewed its website after a long delay, and will be updating content over the next few weeks. First off is the events page advertising:
Our Digital health safety conference on 7th November at Cocoon Networks, London, is being run jointly with DigitalHealth.London – the MHRA has now confirmed they will present so we have almost all the relevant organisations and experts in the UK speaking at this event which should be essential attendance for all involved with the development and use of digital health & care. Attendance has increased substantially in the past few days so do book soon to be sure of securing a place. Much more, including an almost-finalised agenda, is here.
DHACA Day XV – we are back to our usual location at the Digital Catapult Centre on 10th January where are building an agenda of some extremely interesting speakers. To check out the agenda development and to book in advance, go here.
Distance concierge medicine: telemedicine connects US doctors to Chinese patients
Another ‘burden shift’ in medical care. As we in the US wrestle with the issues of telemedicine, cross-state consults, and payment parity, companies are finding a niche in cross-border international virtual consults. A startup in NYC, Docflight, now connects Chinese patients to a claimed several hundred US doctors from prestigious medical centers: Dana-Farber Cancer Center, NYU Langone, Brigham and Women’s Hospital, Massachusetts General, New York-Presbyterian, and others. Founded by Sally Wang, an attorney with a MPH, she developed the idea after negotiating the US healthcare system for her mother with breast cancer and considering how difficult it would be in China to do the same.
The patients pay an upfront fee of about $2,000 in what is essentially long-distance concierge medicine. Docflight first screens the patient, then recommends an appropriate specialist. Once matched, Docflight collects the patient’s medical records (machine translated then human reviewed) and schedules the consult time. The US doctor then advises their Chinese patient on health issues and performs a virtual visit, often with an attending Chinese doctor, and offers recommendations for treatment in an average 45 minute session. The doctors cannot prescribe, perform treatments or procedures.
China has a burgeoning middle class and an aging population, which in combination with the hospital-based system of care in China means that individual patients receive little time with a physician, don’t have a personal relationship with one or more doctors, and don’t expect much of a personal relationship with their doctor. Their government is trying to swing the balance to a primary care model, but with 1.4 bn people that will take awhile. Telehealth and remote patient monitoring is one avenue being explored [TTA 12 Oct 16] but for acute care, a different model is needed. For the Chinese middle class, Docflight is an alternative to medical tourism, a time-tested safety valve for the affluent commonplace for patients from Canada, Latin America, the Middle East, and Asia to international medical centers, though Docflight will arrange such trips to the US.
It’s reasonable that healthcare crosses borders to increase access and overcome language barriers. We’ve previously profiled Mexico’s Salud Interactiva, which provides telephonic consults within the country plus select services through partners ConsejoSano (US) and Konsulta MD (Philippines) [TTA 16 Aug]. Dictum Health, an early-stage health tech company dual-headquartered in Dubai and Oakland, Calif., provides telehealth/telemedicine services long-distance to clinics in Costa Rica, refugee camps in Jordan, and oil rigs [TTA 19 Sep]. Crossing borders to burden-shift care and using technology to facilitate it is a trend to watch for in 2018. NBC News (video), Bold Global Media (video), Crunchbase Hat tip to reader Jeanmarie Tenuto of Healthcare Technical Solutions.
Louisville’s Thrive Center showcases senior care technologies (KY)
Louisville, Kentucky is not the place our Readers would put at the top of their minds when thinking about assistive technologies for older adults, but the debut last week of The Thrive Center may change that. It’s a public-private partnership between the Commonwealth of Kentucky and Louisville Metro with private technology and senior living companies. It showcases technologies transforming senior care on a permanent, updating basis and demonstrated in use.
The Center includes in their 7,500 square foot setting Samsung technologies integrated into a full-size kitchen, bathroom, living room and bedroom; AppliedVR virtual reality headsets; headphones from Eversound; brain fitness software from Posit Science; and music-as-medicine solutions from SingFit and wellness apps from EVŌ. The opening theme is assistance for memory care, which implies that the exhibits will be shifted to different themes in the future.
Companies which helped to establish Thrive include CDW Healthcare (IT), Samsung, Intel, Ergotron, Lenovo, HP/Aruba, Kindred Healthcare (post-acute care) and skilled nursing provider Signature HealthCare. Kindred and Signature are located in Louisville, which is a healthcare hub of the mid-South. It is also the headquarters of Humana and an operations center for Care Innovations–both notably absent from the partner list. CDW release, Senior Housing News, Thrive Center website, Thrive Center release.
Impact of IP telephony on UK telecare systems
The Telecare Services Association (TSA) in the UK has recently released a white paper addressing the impact of a fundamental change to the [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/connecting-people-saving-lives.jpg” thumb_width=”150″ /]UK Public Switched Telephone Network (PSTN) that is now being contemplated. This change will eventually see the replacement of the current PSTN and Integrated Services Digital Network landline networks with IP telephony (the type of phone connectivity that has been commonly used in most modern office environments for some years).
Two years ago BT, who essentially owns practically the whole of the UK PSTN, proposed that the change of their network would be completed in 2025.
This has an impact on the telecare services to the extent that many telecare alarm devices in use connect to the call centres via the PSTN and hence such devices and/or the infrastructure used by suppliers of such services will need to be upgraded when the underlying network is changed. There are, according to the TSA paper, 1.7 million users of such devices in the UK.
The TSA is essentially the UK industry body for telecare and telehealth and as such it is understandably trying to raise awareness of the need for both the commissioners and suppliers of these services to prepare for the change. This paper is said to be a result of gathering views from “key stakeholders” related to this change.
The potential impact, however, seems to be somewhat exaggerated. It should be remembered that the UK very successfully underwent another major switch-over not that long ago in 2012 – from analogue to digital TV. It required every analogue TV in the country to be either fitted with a set top box or replaced with a digital TV.
TSA also suggest that this changeover be used as an opportunity to roll out more internet based digital health functionality to end users. Of course, such functionality is already widely appearing in the form of health monitors, exercise and medication reminders etc. and are not dependent on the switch over. So it is unfortunate that the paper flips between the two topics and asserts a dependence of internet based digital services on the PSTN switch-over.
The document feels more like marketing material than a white paper with about 1/3 of it taken up by irrelevant photographs of random happy smiling or laughing (mostly older) people. It reminded me of some of the material that came out the the 3 Million Lives project. If only our elderly people living alone or in our care homes were as happy as this!
The paper is available to download here.
Clacton’s mystery tack attack scuppers mobility scooters (UK)
(On the lighter, lower-tech side–there are stories that just ask for alliteration running amok, with a few bad puns in tow–Ed. Donna)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/b5eb4fac95dfacc08193ff898623f190-clout-nails-roofing-felt.jpg” thumb_width=”150″ /]Who Is The Tack Saboteur? In the traditional English seaside town of Clacton-on-Sea in Essex, there are quite a few resident pensioners (US=retirees) who use mobility scooters. According to the Telegraph (PDF), Clacton, in fact, has one of the highest numbers of what are also called disability buggies. The Telegraph and the local Clacton Gazette report that someone is not tossing out welcoming rose petals on the sidewalks but new half-inch roofing tacks. This tack (not hack) attack has been keeping local repair shops in the chips repairing punctured tyre tubes, with at least 15 buggy blowouts reported in two weeks. According to a local disability campaigner, it’s revenge on scooterers, who seem to have earned a poor driving reputation on Clacton’s sidewalks. Here’s hoping the local police track down the tacky person who is doing this. On the other hand, buggy driving lessons may also be in order. Hat tip to reader John Boden of ElderIssues (FL), who is alarmed at the prospect of out-of-control buggy drivers.
Japan’s workarounds for adult care shortage: robots, exoskeletons, sensors
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/robear.jpg” thumb_width=”150″ /]The problem of Japan’s aging population–the oldest worldwide with 32 percent aged 60+ (2013, RFE)–and shortage of care workers has led to a variety of ‘digital health solutions’ in the past few years, some of them smart, many of them gimmicky, expensive, or non-translatable to other cultures. There have been the comfort robot semi-toys (the PARO seal, the Chapit mouse), the humanoid exercise-leading robots (Palro), and IoT gizmos. Smarter are the functional robots which can transfer a patient to/from bed and wheelchair disguised as cuddly bears (Robear, developed by Riken and Sumitomo Riko) and Panasonic’s exoskeletons for lifting assistance.
Japan’s problem: how to support more older adults in homes with increasingly less care staff, and how to pay for it. The Financial Times quotes Japan government statistics that by 2025 there will be 2.5m skilled care workers but 380,000 more are needed. The working age population is shrinking by 1 percent per year and immigration to Japan is near-nonexistent. Japan is looking to technology to do more with fewer people, for instance transferring social contact or hard, dirty work to robots. The very real challenge is to produce and support the devices at a reasonable price for both domestic use and–where the real money is–export.
The Abe government in 2012 budgeted ¥2.39bn ($21m) for development of nursing care robots, with the Ministry for Economy, Trade and Industry tasked to find and subsidize 24 companies–not a lot of money and parceled out thinly. Five years later, the Ministry of Health, Labour and Welfare determined that “deeper work is needed on machinery and software that can either replace human care workers or increase staff efficiency.” Even Panasonic concurred that robots cannot offset the loss of human carers on quality of services. At this point. Japan leads in robots under development with SoftBank’s Pepper and NAO, with Toshiba’s ChihiraAiko ‘geisha robot’ (Guardian) debuting at CES 2015 and Toyota’s ongoing work with their Human Support Robot (HSR)–a moving article on its use with US Army CWO Romy Camargo is here. (attribution correction and addition–Ed.)
The next generation of care aids by now has moved away from comfort pets to sensors and software that anticipate care needs. Projects under development include self-driving toilets (sic) that move to the patient; mattress sensor-supplied AI which can sense toileting needs (DFree) and other bed activity; improved ‘communication robots’ which understand and deploy stored knowledge. Japan’s businesses also realize the huge potential of the $16 trillion China market–if China doesn’t get there first–and other Asian countries such as Thailand, a favored retirement spot for well-off Japanese. In Japanese discussions, ‘aging in place’ seems to be absent as an alternative, perhaps due to small families.
But Japan must move quickly, more so than the leisurely pace so far. Already Thailand is pioneering smart cities with Intel and Dell [TTA 16 Aug 16] and remote patient monitoring with Western companies such as Philips [TTA 30 Aug]. There’s the US and Western Europe, but incumbents are plentiful and the bumpy health tech ride tends not to suit Japanese companies’ deliberate style. Can they seize the day? Financial Times (PDF here if paywalled) Hat tip to reader Susanne Woodman of BRE (Photo: Robear)
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